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General NPI Number Information
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NPI Number | 1083020143
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Entity Type | Organization
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Legal Business Name | NORTH SHORE HEALTHCARE, INC.
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Dates
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Enumeration Date | 07/09/2014
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Last Update Date | 04/16/2019
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Provider Practice Location Address
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Address Line | 8755 TRUMBULL AVE SECOND 2ND FLOOR
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City | SKOKIE
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State | IL
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Zip | 60076
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Country | US
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Telephone | 847-213-0483
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Fax | 847-213-0501
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Provider Business Mailing Address
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Address Line | 9944 S ROBERTS RD SUITE 210
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City | PALOS HILLS
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State | IL
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Zip | 60465-1555
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Country | US
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Telephone | 708-658-6545
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Fax | 708-658-6715
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | REHAN AKHTER
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Credential |
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Telephone | 773-886-0473
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 041-211658
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License Number State | IL
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